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General NPI Number Information
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NPI Number | 1467271635
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Entity Type | Individual
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Provider Name | AMY PORTEUS
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Gender | Female
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 3711 RIDGE MILL DR RM 1023
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City | HILLIARD
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State | OH
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Zip | 43026-9554
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Country | US
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Telephone | 614-366-1576
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Fax |
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Provider Business Mailing Address
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Address Line | 5589 ROYAL DUBLIN DR
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City | DUBLIN
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State | OH
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Zip | 43016-9438
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Country | US
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Telephone | 614-832-4829
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03120576
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License Number State | OH
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